Individual
DR. MOHAMAD HYTHAM RIFAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 E 89TH AVE, SUITE 3A, MERRILLVILLE, IN 46410-7318
(219) 756-2900
(219) 756-2910
Mailing address
200 E 89TH AVE, SUITE 3A, MERRILLVILLE, IN 46410-7318
(219) 756-2900
(219) 756-2910
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
01035906
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
087388
ANTHEM
IN
05
—
100214490A
—
IN
01
—
129164100
INDIANA DEPT OF LABOR
IN
01
—
140000847
PALMETTO RR MEDICARE
IN
Enumeration date
06/12/2006
Last updated
10/01/2021
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